Kupukusira kwa chakudya ndi mayamwidwe a michere kuchokera ku chakudya kumachitika chifukwa cha madzi a kapamba omwe amapezeka m'matumbo. Pancreatic secretion imakhala ndi ma enzymes omwe amatsogolera pakugaya chakudya.
Limagwirira kupanga, mitundu ndi ntchito
Kapamba ndi gawo la mankhwala osakanikirana, chifukwa samangotulutsa ma enzymes okha, komanso mahomoni - insulin, glucagon ndi lipocaine. Insulin ndi glucagon imayendetsa kagayidwe kazakudya, ndipo mahomoni ofanana ndi lipocaine amachititsa michere ya chiwindi. Ma Horoni amapezekanso mumadzi a pancreatic ndikuthandizira kugaya bwino m'matumbo ang'onoang'ono.
Chakudya chikadzalowa m'matumbo a kapamba, zimapangitsa kuti pakhale chiphaso. Ili ndi ma enzymes a pancreatic mu mawonekedwe osagwira - ma proenzymes.
Mpanda womwe madzi a pancreatic amalowera mu duodenum 12 amatchedwa Virsungieva duct ndipo umapezeka m'mbali mwake lonse la chisa. Imatha kumbuyo kwa kapamba ndi sphincter ya Oddi. Mwa anthu ambiri, Virsungiev duct imalumikizana ndi wamba duct, ndipo imafikira mu duodenum.
Chotupa cha ndulu chimakumana ndi chakudya chomwe chikubwera ndikumasulidwa kwa bile, yomwe imasakanikirana mumphika wamba ndi madzi a pancreatic. Zitatha izi, kutsegula kwa ma enzymes pokonza mafuta, mapuloteni ndi zakudya zimayamba. Mothandizidwa ndi michere ya enzymatic, michere yambiri imaphwanya mpaka glucose, mapuloteni ku amino acid, mafuta kwa mafuta acid ndi glycerol.
Ma pancreatic enzymes amagwira ntchito yayitali kwambiri pantchito yopukusa chakudya. Chakudya chokonzedwa ndi ma enzymes amalowa m'matumbo aang'ono, momwe michere imayamwa kudzera m'matumbo a m'matumbo kulowa m'magazi, ndikuwapereka kwa ziwalo ndi minofu ya thupi.
Popeza michere yopangidwa ndi kapamba imagwira ntchito komwe kugaya chakudya kumakhala kovuta kwambiri, zosokoneza zilizonse mu chiwalo zimakhudza thanzi la munthuyo. Pali zovuta ndi matumbo (kukhumudwa chopondapo), kumakhala mawonekedwe owoneka osokoneza bongo - kusweka, kutulutsa magazi ndi mseru. Chifukwa cha kuchepa kwa michere ya pancreatic, zinthu zingapo sizikumbidwa, ndipo kapamba amayamba.
Mapulogalamu
Pali mitundu itatu yayikulu ya michere - amylase, lipase ndi proteinase. Ma amylase akuphwanya wowuma ndi chakudya, ntchito ya lipase ndiyo hydrolysis yamafuta, ndipo proteinase ndiyo imapangitsa kuphwanya mapuloteni.
Gulu la proteinase limaphatikizapo exopeptidases, yomwe imaphwanya zomangira za peptide zakunja m'mapuloteni ndi ma peptides, ndi endopeptidases, omwe amachititsa hydrolysis yamkati yamapuloteni-peptide. Exopeptidases imaphatikizapo carboxypeptidase A ndi B, michere ya proteinolytic yomwe imaphwanya zomangira za peptide ndipo ndi gawo limodzi la secretion wa pancreatic.
Endopeptidases ndi pepsin, gastricin ndi chymosin, omwe amabisidwa ndi mucosa wam'mimba, ndi ma pancreatic proenzymes trypsin, chymotrypsin ndi elastase. Ma enzyme a m'mimba amagwetsa molekyulu mapuloteni, amachepetsa hydrochloric acid mpaka 95%.
Chotsatira, michere yapancreatic imaphatikizidwa ndi ntchitoyi, kuwonjezera kuphwanya mapuloteni m'matumbo. Choyamba, trypsin, chymotrypsin ndi elastase zimaphwanya mamolekyulu akulu a protein kukhala ang'onoang'ono - peptides. Kenako, mothandizidwa ndi carboxypeptidase, ma peptides amayatsidwa hydrolyzed kuti amino acid omwe amamwa ndi khoma lamatumbo.
Madzi a pancreatic ali ndi mitundu 6 ya mapuloteni, omwe amasiyana pakapangidwe kogwira ntchito:
- serine;
- threonine;
- cysteine;
- aspartyl;
- metalloprotease;
- glutamine.
Tiyenera kudziwa kuti ma protein ndi gawo la mankhwala ambiri omwe amakhala ndi ma enzymes omwe amagwiritsidwa ntchito kuti abwezeretse ntchito ya pancreatic ndikuchotsa zizindikiro zoyipa.
Amylase
Ma encyme amylolytic pancreatic amasokoneza zakudya zotsekemera kukhala mas shuga osavuta otchedwa oligosaccharides. Ndithokoza amylase kuti zipatso zamtundu wamtundu wamtundu wina zimawonekera mutatha kudya zakudya zokhazikika - mwachitsanzo, mpunga kapena mbatata. Enzyme iyi imapezekanso pamasamba, mothandizidwa ndi momwe kugaya chakudya kumayambira.
Pamkamwa pakamwa, wowuma amawonongeka mpaka dextrin, ndipo dextrin ndi maltose amapangidwa chifukwa chogwiritsa polysaccharides ndi madzi a m'mimba. Gawo lomaliza ndikuphika kwa chakudya chamagulu am'madzi mu duodenum 12 mu glucose ndi fructose motsogozedwa ndi Y-amylase.
Ma enzymes amylolytic amaphatikiza lactase, yomwe imaphwanya lactose (shuga mkaka) yomwe ili muzinthu zamkaka.
Kuperewera kwa enzyme kwa amylase kungasonyeze kukulira kwa ma pathologies angapo: kapamba, matumbu (maps), matenda a shuga komanso zotupa za m'mimba.
Lipase
Ma enzyme a Lipolytic amakhala ngati othandizira a lipid hydrolysis ndikuphwanya mafuta omwe amalandidwa m'thupi. Lipase imayendetsedwa m'matumbo ndipo imaphwanya zakudya zamafuta kukhala glycerin ndi mafuta ochulukirapo. Enzimuyi imagawidwa m'magawo a hydrophilic ndi hydrophobic omwe amangogwira ntchito pamadzi okhaokha. Chifukwa chake, chofunikira pakufinya kwa mafuta ndicho magawo awo kukhala magawo ang'onoang'ono a bile - motero, dera lolumikizana ndi lipase limakulirakulira.
Mlingo wowonjezereka wa lipase poyesa magazi amawonedwa m'njira zosiyanasiyana zam'matumbo ndi impso, matenda a metabolic (matenda a shuga, gout, kunenepa kwambiri, peritonitis, ndi mamps. Nthawi zina, index ya lipase imachuluka chifukwa cha chithandizo cha nthawi yayitali ndi barbiturates, analcics ya narcotic, Heparin ndi Indomethacin.
Ngati palibe lipase yokwanira m'thupi, ndiye kuti chifukwa chake chimatha kuchepa kwa ntchito ya pancreatic, cystic fibrosis (cystic fibrosis), kukula kwa neoplasms yoyipa m'ziwalo zilizonse kupatula ziphuphu. Nthawi zina mulingo wochepetsetsa wa lipase umachitika chifukwa cha chakudya chosagwirizana ndi zakudya zamafuta ambiri.
Kuzindikira ndi zizindikiro za kuchepa kwa ntchito ya exocrine
Pofuna kudziwa kuti ndi ma enzymes a kapamba omwe satulutsa zochuluka motani, kuyesa kwa labotale kumachitika. Malinga ndi zotsatira za kuyesedwa kwa magazi, mkodzo ndi ndowe, maphunziro othandizira, komanso kuganizira zomwe zilipo, kukonzekera kwa enzyme kungathe kutumizidwa.
Miyezo yomwe ili ndi ma enzymes ndi awa:
- magazi: amylase - 29-99, lipase - 22-66, trypsin - 19.7 - 30.3 mg / l;
- seramu yamagazi: elastase - 01 - 4 ng / ml;
- mkodzo: amylase (diastase) - max 100 magawo / l;
- Pulogalamu: elastase - kuchokera 200 mcg / g.
Ma pancreatic enzi amapangidwa mu ma acinar cell a kapamba, ndiye kudzera mu tubules tating'onoting'ono timalowa m'malo akuluakulu omwe amapanga duct wamkulu - Virsungs
Kuperewera kwa michere ya pancreatic kumayambitsa kuphwanya kwamkati ntchito yam'mimba ndi thupi lonse. Pankhani ya kupanga michere mopitirira muyeso, kupweteka kwamatumbo kumayambika - kapamba. Kuchepetsa kaphatikizidwe ka michere kumatanthauza kusintha kwa matendawo kukhala mawonekedwe osakhazikika.
Zotsatira zotsatirazi zimatha kubweretsa kusintha kwakukuru ndi kowononga m'mapazi komanso m'malo mwa timene timakanika ndi minyewa:
- kudya kwambiri ndikuzunza zakudya zamafuta, zakumwa zoledzeretsa;
- kukhalapo kwa neoplasms - cysts, zotupa (zonse zosaopsa ndi zoyipa), fibrosis;
- matenda a duodenum ndi biliary thirakiti;
- opaleshoni yamapamba.
Ndi kuchepa kwa ma enzymes, zizindikiro zingapo zamtunduwu zimatuluka:
Momwe mungayang'anire kapamba- polyfecal (ndowe zochuluka za ndowe);
- Wokhala phala, mapando otayirira a utoto wonyezimira, wokhala ndi mafuta komanso fungo losasangalatsa;
- kukhalapo kwa zidutswa za chakudya chosagwiritsidwa ntchito munthaka;
- kumverera kwodzaza ndi m'mimba ndi mseru, kutentha kwa mtima;
- kukoma koyipa mkamwa;
- kuchepa kwa chakudya;
- kusefukira kwamkati, kukugwa m'mimba;
- kuwonda, kuchepa magazi, kufooka, kugona ndi mutu;
- m'mimba kupweteka atatha kudya;
- tsankho lamafuta azakudya ndi zonunkhira.
Popeza lipase synthesis makamaka imachepetsedwa, chisokonezo cha stool ndi chimodzi mwazomwe zimayamba - zimakhala zowoneka bwino kapena zowonda pang'ono. Ndizofunikira kudziwa kuti zizindikirazi zimafanana komanso ndi kuchuluka kwa michere, komanso kuchepa. Komabe, pankhani yopanga ma enzyme ambiri, kutentha kwa thupi kumatha kuwonjezeka, ndipo ululu wammbuyo umakhala wakuthwa, wotchulidwa.
Kuphwanya kwa exocrine ntchito ya kapamba kumafunika kuvomerezedwa, chifukwa kungayambitse kukula kwa matenda oopsa monga chifuwa chachikulu cha m'mimba, zilonda zam'mimbazi, chiwindi ndi matenda am'mimba.
Mankhwala okhala ndi enzyme
Ma Enzymes a kapamba amalembedwa malinga ndi zotsatira za mayeso komanso kutengera zomwe zilipo. Mlingo komanso mlingo wa mankhwalawa zimatengera zaka komanso kulemera kwa wodwalayo, komanso mawonekedwe a matendawa. Mankhwala obwezeretsanso enzyme, mankhwalawa amagwiritsidwa ntchito omwe amaphatikizapo lipase, amylase ndi trypsin. Izi ndiye, choyambirira, Pancreatin ndi zotumphukira zake - Creon, Mezim Forte, Pangrol, Panzitrat, etc.
Nthawi zambiri, madokotala amalimbikitsa kutenga Creon, chifukwa imagwira bwino komanso ili ndi zabwino zake. Creon sichikupezeka pamapiritsi, koma m'mapiritsi omwe amatetezedwa kawiri. Chibowo chilichonse chimakhala ndi ma microspheres ambiri a mini, omwe samagwa mchikakamizo cha hydrochloric acid am'mimba ndikufika komwe akupita - m'matumbo. Kuphatikiza apo, kapangidwe ka Creon kamaphatikizira dimethicone, yomwe imachepetsa kupanga.
Mankhwala angapo ali ndi kuphatikiza, othandizira ndi zigawo za bile. Amawerengera matenda amtundu wa chiwindi ndi ndulu. Mankhwala osakanikirana akuphatikizapo Festal, Digestal, Kotazim Forte, Enzistal.
The Unienzyme yozikidwa pa enzyme papain yothandizira imalimbikitsa kugaya kwathunthu mapuloteni, mafuta ndi chakudya, imatha kuyamwa, kupatsa mphamvu komanso kupondereza kupangidwa kwa mpweya
Mu pancreatitis yayikulu, ma enzyme zoletsa zomwe zimachepetsa zochitika za kapamba - Somatostatin, Kontrikal, Ingitril, Glucagon, Gordoks, etc. amagwiritsidwa ntchito poyamba. Atayimitsa kaye ziwonetsero zazikuluzo, amasintha kupita ku mankhwala okhala ndi enzyme.
Pankhani ya zolakwika pazakudya kapena ndi mawonekedwe ofinya a kapamba, ma enzyme a chomera angagwiritsidwe ntchito - mwachitsanzo, Oraza, Pepfiz, Unienzyme, Wobenzym, Solizim, Abomin.
Zakudya zopindulitsa
Kuti mupeze zotsatira zabwino kuchokera ku chithandizo cha enzyme, muyenera kudya zakudya zoyenera. Zimakhazikitsidwa ndi mfundo za zakudya No. 5, zomwe zimathandizira kwambiri kuchira:
- kupatula - kuchuluka kwa zakudya patsiku sikuchepera 5;
- kulemera kwa wotumikirapo sikuyenera kupitirira 200 g .;
- mbale zonse zimawotchera, mu uvuni kapena kuwotcha;
- kutentha kutentha - pafupifupi 35-40 °;
- mafuta, okazinga, mowa ndi woletsedwa.
Nyama yotentha ndi nsomba zamitundu yochepa yamafuta, mazira a nkhuku, buckwheat, oatmeal, maapulo, nthochi ndi tchizi cha kanyumba ndizoyenera kugwiritsa ntchito.
Kubwezeretsa ntchito ya pancreatic kudzera mu kukonzekera kwa enzyme, kuyezetsa ndikofunikira. Kutengera zotsatira za wodwala aliyense, mankhwala amasankhidwa ndi mtundu wa mankhwala omwe amasankhidwa.
